title: Hepatitis E virus seroprevalence and risk factors for individuals in working contact with animals.
abstract: BACKGROUND
  In industrial countries genotypes 3 and 4 of HEV are detected in swine, wild boar, deer and rabbits, and they are associated with autochthonous infections suggesting the existence of zoonotic HEV infections, compatible with the putative involvement of undercooked pork and big game products as a source of infection.
  
  
  OBJECTIVE
  To evaluate the prevalence of anti-HEV antibodies in different population groups in contact with animals and to investigate risk factors for HEV infection.
  
  
  METHODS
  Serum samples were collected from 859 healthy French subjects, including pig farm workers, forestry workers and individuals without working contact with animals (control group). In addition, 58 swine veterinarians were included in the study. Subjects were interviewed using a structured questionnaire, and anti-HEV antibodies were investigated using a sensitive and specific sandwich ELISA.
  
  
  RESULTS
  Anti-Hepatitis E virus (HEV) antibodies were detected in 26% of control population, and in 36% and 44% of forestry and pig farm workers, respectively. In addition, an increase in seroprevalence from the north to the south of France was observed (30.2% versus 40.7%). Consumption of pork liver sausage (AOR 4.4, p < 10(-4)), occupational contact with animals (AOR 1.58, p = 0.038 for forestry workers and AOR 2.51, p < 10(-4) for pig farm workers), and living in southern France (AOR 1.47, p = 0.02), were independent risk factors. Wearing working gloves and boots might reduce HEV infection.
  
  
  CONCLUSIONS
  Occupational exposure to animals and consuming raw or undercooked pork liver sausage or pork liver play a significant role in HEV transmission in industrial countries.
authors.affiliation: CHRU de Tours, Service de Médecine Interne & Maladies Infectieuses, 2 Boulevard Tonnellé, 37044 Tours Cedex 9, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Chaussade
authors.forename: Emma
authors.initials: E
authors.lastname: Rigaud
authors.forename: Aurore
authors.initials: A
authors.lastname: Allix
authors.forename: Audrey
authors.initials: A
authors.lastname: Carpentier
authors.forename: Antoine
authors.initials: A
authors.lastname: Touzé
authors.forename: Didier
authors.initials: D
authors.lastname: Delzescaux
authors.forename: Patrick
authors.initials: P
authors.lastname: Choutet
authors.forename: Nathalie
authors.initials: N
authors.lastname: Garcia-Bonnet
authors.forename: Pierre
authors.initials: P
authors.lastname: Coursaget
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D004797:Enzyme-Linked Immunosorbent Assay; D005247:Feeding Behavior; D005602:France; D006508:Hepatitis Antibodies / Q000097:blood*; D016751:Hepatitis E / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D011817:Rabbits; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D006508:Hepatitis Antibodies
keywords: ALT; AOR; ELISA; Forestry workers; HEV; Hepatitis E virus; OR; Pig handlers; Pork liver sausage; RNA; Seroprevalence; adjusted odds ratio; alanine transaminase; enzyme linked immunosorbent assay; odds ratio; ribonucleic acid